CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Sartori Memorial Hospital, Inc

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $63
  • Cash Discount Price: $1,313
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Sartori Memorial Hospital, Inc is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,313. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 515 College Street, Cedar Falls, IA.
Cash / Self-Pay
$1,313

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)
Cash / Self-Pay: $1,313 (4012%)
Insurance Median: $63 (192%)
Cash: $1,313 (4012% of Medicare)
Ins. Median: $63 (192% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $32.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Iowa Total Care $26 79%
Medicaid / KanCare $27 82%
Aetna $31 - $302 95%
Blue Cross Blue Shield $31 95%
Medicare (plans) $31 - $32 95%
UnitedHealthcare $31 - $284 95%
Health Choices $32 98%
Medical Associates $32 98%
Amish Hospital Aid $42 128%
Health Partners $45 137%
Oscar $48 147%
Centivo $52 159%
Ambetter / Centene $53 162%
Claimdoc $63 192%
Nova $63 192%
Auxiant $97 296%
Cigna $97 296%
Medica $97 296%
Midlands $97 296%
Midlands Choice $97 296%
Iowa Dept Of Public Health $137 419%
Geha $284 868%
Allied Benefit Systems $302 923%
Asr Health Benefits $302 923%
Coventry $302 923%
First Health $302 923%
Lucent Health $302 923%
Luminare Health $302 923%
Medical Mutual $302 923%
Meritain $302 923%
Webtpa $302 923%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 515 College Street, Cedar Falls, IA 50613
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals